Baby Esther A., 1

Baby Esther is the second twin and the youngest of four children. She lives with her parents and siblings in a single-room mud-walled house. Her mother is unemployed, leaving the entire household dependent on her father, who survives through irregular menial jobs. Some days he finds work carrying loads, digging or assisting at construction sites, while on other days he returns home without earning anything. His unpredictable income must provide food, rent, clothing and other necessities for the entire family, leaving no savings for unexpected medical expenses. Esther was born prematurely at 34 weeks’ gestation weighing only 1,200 g, making her a very-low-birth-weight preterm infant at increased risk of serious neonatal complications. Soon after birth, she developed difficulty breathing. She required urgent transfer to the NICU, where she was placed in an incubator for temperature control and received oxygen therapy, infection-prevention measures, feeding support and close monitoring. These interventions were essential to stabilize her breathing and protect her from complications associated with prematurity. With continued specialized neonatal care and good clinical progress,

Baby Esther is a 34-week preterm, very-low-birth-weight infant weighing 1,200 g, placing her at increased risk of respiratory distress, hypothermia, infection, feeding difficulties and poor weight gain. Her early breathing difficulty is likely related to lung immaturity and inadequate surfactant. NICU admission, incubator care, oxygen support, feeding assistance and close monitoring were medically necessary. With continued specialized neonatal care and good response to treatment, her prognosis is cautiously favourable, with recovery and appropriate weight gain expected.